Author Interviews, Schizophrenia / 25.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48829" align="alignleft" width="130"]Dolores Malaspina MD, MS, MSPHPROFESSOR | Psychiatry, Neuroscience, Genetics and Genomic SciencesIcahn School of Medicine at Mt SinaiDepartment of PsychiatryNew York, NY 10128, USA Dr. Malaspina[/caption] Dolores Malaspina MD, MS, MSPH Professor or Psychiatry, Neuroscience, Genetics and Genomic Sciences Icahn School of Medicine at Mt Sinai Department of Psychiatry New York, NY 10128, USA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a severe disorder that presents in late adolescence or early adulthood with declining function, social withdrawal and psychotic symptoms such as auditory hallucinations and fixed false beliefs. It is a common condition, affecting 1% of the population, which can be not yet be prevented or cured. Its causes are still puzzling. Evidence from many different research approaches now suggests that an overactive immune system plays some role in causing schizophrenia, but the origins of the immune dysfunction are not known. We considered that too brief a period of sexual contact between parents could cause immune activation in offspring and thus be a risk factor for schizophrenia. With repeated sexual contact the maternal immune system develops tolerance to genetic material from the father. Otherwise, inflammatory processes may restrict the placental blood supply between the fetus and mother.
Author Interviews, Endocrinology, Thyroid Disease / 31.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48168" align="alignleft" width="133"]Terry Davies, MD, ProfessorMedicine, Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount SinaiCo-Director, The Thyroid Center, Mount Sinai Union Square Dr. Davies[/caption] Terry Davies, MD, Professor Medicine, Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai Co-Director, The Thyroid Center, Mount Sinai Union Square MedicalResearch.com: What is the background for this study? What are the main findings? Response: The receptor for thyroid stimulating hormone (TSH) is the major antigen for Graves' disease and patients have unique antibodies to the TSHR which stimulate excessive thyroid hormone secretion. We have characterized a variant TSHR called v1.3 which is a splicing variant which we find expressed in thyroid, bone marrow, thymus and adipose tissue and incorporates an intronic sequence which is fully translated. 
Author Interviews, Heart Disease, JAMA, Stem Cells / 26.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48147" align="alignleft" width="114"]Annetine C. Gelijns, PhDChair, Department of Population Health Science & PolicyEdmond A. Guggenheim Professor of Health PolicyCo-Director, InCHOIR Dr. Gelijns[/caption] Annetine C. Gelijns, PhD Professor and System Chair Population Health Science and Policy Icahn School of Medicine at Mount Sinai [caption id="attachment_48148" align="alignleft" width="114"]Alan J Moskowitz, MDProfessor, Population Health Science and PolicyDepartment of Population Health Science & PolicyIcahn School of Medicine at Mount SinaiNew York, NY 10029-6574 Dr. Moskowitz[/caption] Alan J Moskowitz, MD Professor of Population Health Science and Policy Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Where do these mesenchymal cells come from?  Response: Implantable LVADs significantly improve the survival and quality of life of advanced heart failure patients. However, these devices are associated with substantial adverse events, including infection and thromboembolic events. Moreover, whereas these devices improve myocardial function, few patients recover sufficient function to be explanted from their LVAD. These observations have focused attention on stem cells as a possible adjunctive therapy to further augment cardiac recovery. Mesenchymal precursor cells (MPCs), which are obtained from healthy donors and culture-expanded, have been shown in animal and early human studies to improve cardiac function. Using temporary weaning as a signal of cardiac recovery, we conducted an exploratory trial in the Cardiothoracic Surgical Trials Network (CTSN), which found that MPCs increased the probability of temporary weaning from full LVAD support compared to sham-control patients. Therefore, this signal of efficacy led the CTSN to design our current follow-up trial evaluating the efficacy and safety of a higher dose of MPCs in LVAD patients.
Author Interviews, Endocrinology, Gender Differences, Hormone Therapy / 26.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48102" align="alignleft" width="133"]Joshua Safer, MD, Executive DirectorCenter for Transgender Medicine and SurgeryMount Sinai Health SystemSenior Faculty, Medicine, Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount Sinai Dr. Safer[/caption] Joshua Safer, MD, Executive Director Center for Transgender Medicine and Surgery Mount Sinai Health System Senior Faculty, Medicine, Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: The standard trans feminizing hormone regimen includes estrogen both to suppress testosterone and so that the individual has sufficient circulating sex hormone in the body for good bone health. After orchiectomy, there is no need to suppress testosterone because the levels are very low and it is common to cut the estrogen dose in half.  Cis women with premature ovarian failure often take about 2 mg of estradiol daily so that dose has seemed reasonable for trans women without testes.  However, when my co-author Sira Korpaisarn and I checked estradiol levels and gonadotropins (pituitary hormones, LH and FSH) as a guide to dosing, we found that based on that testing, trans women may require higher doses of estrogens than the 2 mg that we expected.
Author Interviews, Endocrinology, Genetic Research / 24.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48099" align="alignleft" width="200"]Emily J. Gallagher, MDAssistant Professor of MedicineEndocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount Sinai  Dr. Gallagher[/caption] Emily J. Gallagher, MD Assistant Professor of Medicine Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? Response: Multiple Endocrine Neoplasia Syndrome Type 2 (MEN2) is an inherited endocrine disorder characterized by the development of pheochromocytoma, medullary thyroid carcinoma (MTC) and parathyroid tumors. It occurs due to activating missense variants in the RET gene. The estimated prevalence of MEN2 is 1 per 30,000 in the general population. Through a collaboration between The Center for Genomic Health, the Charles Bronfman Institute for Personalized Medicine, and the Division of Endocrinology at Mount Sinai, our aim was to investigate the prevalence and clinical manifestations of pathogenic RET variants in the multi-ethnic BioMe Biobank. The BioMe Biobank is an electronic health record-linked biobank with exome sequencing data available for more than 30,000 patients recruited across The Mount Sinai Health System.
Author Interviews, Erectile Dysfunction, Heart Disease / 20.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48010" align="alignleft" width="130"]Jagat Narula, MD, PhDPhilip J. and Harriet L. Goodhart Professor of Medicine (Cardiology)Associate Dean for Global HealthDirector of the Cardiovascular Imaging ProgramMount Sinai Medical Center Dr. Narula[/caption] Jagat Narula, MD, PhD Philip J. and Harriet L. Goodhart Professor of Medicine (Cardiology) Associate Dean for Global Health Director of the Cardiovascular Imaging Program Mount Sinai Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atherosclerosis has been linked to causing erectile dysfunction (ED) in the majority of patients with this cardiovascular condition, but researchers have not had the means of demonstrating atherosclerosis in penile arteries until now.  This unique study uses advanced imaging to detect how strong the association actually is.  For the first time, researchers have used advanced imaging of penile arteries to show a link between atherosclerosis and erectile dysfunction (ED).
Author Interviews, Heart Disease, JACC, Technology / 20.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48004" align="alignleft" width="130"]Annapoorna Kini, MDZena and Michael A Wiener Professor of MedicineDirector of the Cardiac Catheterization LaboratoryMount Sinai Heart at Mount Sinai Hospital Dr. Kini[/caption] Annapoorna Kini, MD Zena and Michael A Wiener Professor of Medicine Director of the Cardiac Catheterization Laboratory Mount Sinai Heart at Mount Sinai Hospital MedicalResearch.com: What is the background for this study?  
  • Expanding indication and use of Transcatheter aortic valve replacement (TAVR) poses a unique problem of coronary access after valve implantation.
  • Troubleshooting tools and techniques have been published but are not available at the fingertips of the user at all the times.
  • We tried to address this unique problem with an innovative educational mobile application (app) called "TAVRcathAID".
Accidents & Violence, Author Interviews, Heart Disease, Inflammation, JACC, Lipids / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47835" align="alignleft" width="200"]Dr. George Dangas MD PhDProfessor of Medicine, CardiologyMount Sinai Health System Dr. Dangas[/caption] Dr. George Dangas MD PhD Professor of Medicine, Cardiology Mount Sinai Health System MedicalResearch.com: What is the background for this study? Response: Widespread use of statins targeted to decrease levels of low density lipoprotein cholesterol (LDL-C) below 70mg/dL are recommended by guidelines. However, residual cholesterol risk may only be one part of the residual risk equation. Indeed, Biological inflammation has long been known as a pathophysiological mechanism of atherosclerosis and the recent CANTOS trial opened new therapeutic perspective by demonstrating that inflammation modulation via selective interleukin-1β inhibition could result in improved diagnosis in patients with coronary artery disease. However, the prevalence and impact of a residual inflammatory biological syndrome in patients with controlled cholesterol risk is unclear.
Author Interviews, Opiods, Orthopedics / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47877" align="alignleft" width="130"]Paul Cagle, Jr. MDAssistant Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Cagle[/caption] Paul Cagle, Jr. MD Assistant Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings ie What are some of the significant comorbidities?  Response: In this study our goal was to better understand what medical issues (medical comorbidities) can cause trouble or issue for patients with a proximal humerus fracture (shoulder fracture).  To tackle this issue we used a large national sample of patients and sorted our the different medical issues the patients had. We found that patients with increased medical issues had longer hospital stays and higher use of opioid medications (pain medications).
Author Interviews / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47740" align="alignleft" width="130"]Darwin Chen, MD Assistant Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Chen[/caption] Darwin Chen, MD Assistant Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Periprosthetic joint infection unfortunately remains a leading cause of total knee arthroplasty failure. One method of mitigating the risk of PJI is to use antibiotic loaded bone cement in a prophylactic fashion. While the use of antibiotic cement makes inherent sense, the decision is not as simple as it seems. There are potential side effects such as renal damage, antibiotic hypersensitivity, and antibiotic resistance. Antibiotics decrease the mechanical strength of cement fixation, which may impact component loosening. Additionally, antibiotic cement is significantly more expensive than standard cement, driving up cost. Currently there is no consensus on if antibiotic cement truly reduces infection risk and there are many conflicting studies. The purpose of our study is the use a large national database to evaluate real world utilization patterns of antibiotic cement, and assess outcomes, complications, and cost associated with antibiotic cement usage. Our hypothesis was that antibiotic cement is associated with a decreased risk of infection and no increased risk of systemic complications. 
Author Interviews, Opiods, Orthopedics, Surgical Research / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47736" align="alignleft" width="130"]Dr. Alexis Colvin, MDAssociate Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Colvin[/caption] Dr. Alexis Colvin, MD Associate Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? Response: 40% of all opioid overdose deaths involve a prescription opioid and orthopaedic surgeons are the 3rd highest prescribers of opioids.  Set guidelines for post surgery opioid prescriptions have not been established.  Arthroscopic knee meniscectomy is one of the most common orthopaedic procedures.  The purpose of this study was to determine how many opioids were being prescribed  among a group of six sports fellowship trained orthopaedic surgeons versus how many patients were actually using.
Author Interviews, Personalized Medicine, Weight Research / 19.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47503" align="alignleft" width="130"]Ruth Loos, PhD The Charles Bronfman Professor in Personalized Medicine Director, Genetics of Obesity and Related Traits Program Co-Director, Charles Bronfman Institute for Personalized Medicine Icahn School of Medicine at Mount Sinai New York, NY Dr. Loos[/caption] Ruth Loos, PhD The Charles Bronfman Professor in Personalized Medicine Director, Genetics of Obesity and Related Traits Program Co-Director, Charles Bronfman Institute for Personalized Medicine Icahn School of Medicine at Mount Sinai New York, NY     MedicalResearch.com: What is the background for this study? Which type of body fat distribution carries greater risk of diabetes or other obesity-related health disorders? Response: Obesity broadly consists of two component; [1] there is overall body size (assessed using BMI) and [2] there is fat distribution (assessed using WHR). Both are “heritable”, which mean that they are in part determined by our genome (and the other part is determined by our lifestyle). Over the past 15 years, geneticists have used an approach to screen the whole genome of thousands of people to identify genetic variations that differ between e.g. obese people vs non-obese people. We have applied this approach to both components of obesity and have found so far that genes for “overall body size” seem to act in the brain, likely controlling hunger, satiety, reward, etc., whereas the genes that determine where in the body the excess fat will be stored when you gain weight (i.e. fat distribution) seem to act more “locally” at the fat cell level itself, determining the storage and release of fat. 
Author Interviews, MRI, Prostate Cancer, Technology / 12.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47464" align="alignleft" width="130"]Gaurav Pandey, Ph.D. Assistant Professor Department of Genetics and Genomic Sciences Icahn Institute of Data Science and Genomic Technology Icahn School of Medicine at Mount Sinai, New York  Dr. Pandey[/caption] Gaurav Pandey, Ph.D. Assistant Professor Department of Genetics and Genomic Sciences Icahn Institute of Data Science and Genomic Technology Icahn School of Medicine at Mount Sinai, New York  MedicalResearch.com: What is the background for this study?  Response: Multiparametric magnetic resonance imaging (mpMRI) has become increasingly important for the clinical assessment of prostate cancer (PCa), most routinely through PI-RADS v2, but its interpretation is generally variable due to its relatively subjective nature. Radiomics, a methodology that can analyze a large number of features of images that are difficult to study solely by visual assessment, combined with machine learning methods have shown potential for improving the accuracy and objectivity of mpMRI-based prostate cancer assessment. However, previous studies in this direction are generally limited to a small number of classification methods, evaluation using the AUC score only, and a non-rigorous assessment of all possible combinations of radiomics and machine learning methods.
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